scholarly journals Changing pattern of resistant pathogens causing urinary tract infections in Karachi

2013 ◽  
Vol 2 (3) ◽  
pp. 105-110
Author(s):  
H Najmul ◽  
A Tanveer

INTRODUCTION: The study under view is based under the aim to investigate the prevalence and susceptibility pattern of pathogens, causing urinary tract infections (UTIs), to antibiotics commonly used in routine medication. MATERIALS AND METHODS: Over a period of 10 months 100 isolates were collected for the determination of their susceptibility to chosen antibiotics, from a laboratory (MedPath Laboratories) in urban area of Karachi. All Gramnegative and Gram-positive urinary tract pathogens were re-identified by their morphological and biochemical characteristics and the susceptibility to seven antibiotics was determined. RESULTS: Pathogens were found as, Escherichia coli, Pseudomona spp, Klebsiella species, Enterobacter spp., and Staphylococci spp. In recent study, more than half of the Escherichia coli isolates were resistant to one or more of the all antimicrobial drugs tested. Resistance was most common to amoxicillin/clavulanic acid and ofloxacin, cefixime, followed by gentamicin. Our results indicate that Escherichia coli and Pseudomonas spp. were the most common organisms causing UTI. Other organisms involved were Enterobacter spp., Staphylococcus spp., and Klebsiella spp. Increasing patterns of resistant to gentamicin, and ofloxacin were also observed. CONCLUSIONS: In conclusion, pattern of antibiotic susceptibility to first line antibiotics is changing hence antimicrobial susceptibility testing of all isolates is crucial for the treatment of UTI. DOI: http://dx.doi.org/10.3126/ijim.v2i3.8069 Int J Infect Microbiol 2013;2(3):99-104  

Author(s):  
Rachana Kanaujia ◽  
Amit Kumar ◽  
Malay Bajpai

Background: Urinary tract infections (UTIs) are one of the most common infections. For treatment of UTIs, there are limited antibiotics due to increased resistance among uropathogens. Two older antibiotics; Nitrofurantoin and Fosfomycin have become novel oral therapeutic options against uropathogens. Aim of the study was to identify UTI causing micro-organisms and evaluate in-vitro activity of nitrofurantoin and fosfomycin against most common isolated organism (E. coli).Methods: Results of urine samples culture and susceptibility testing over a period of 1 year were analysed and included in this study.Results: Micro-organisms were isolated from 568 urine samples. Most commonly isolated organism was Escherichia coli (40.50%), followed by Klebsiella spp. (20.07%) and Staphylococcus spp. (17.07%). Susceptibility of E. coli to nitrofurantoin and fosfomycin was 91.74% and 65.65% respectively. Conclusion: Good activity of nitrofurantoin and fosfomycin against E. coli indicates that these two drugs are potential therapeutic alternatives for urinary tract infections.


Author(s):  
Mengistu Abayneh ◽  
Getnet Tesfaw ◽  
Alemseged Abdissa

Background. Klebsiella pneumoniae and Escherichia coli are the major extended-spectrum β-lactamase- (ESBL-) producing organisms increasingly isolated as causes of complicated urinary tract infections and remain an important cause of failure of therapy with cephalosporins and have serious infection control consequence. Objective. To assess the prevalence and antibiotics resistance patterns of ESBL-producing Escherichia coli and Klebsiella pneumoniae from community-onset urinary tract infections in Jimma University Specialized hospital, Southwest Ethiopia, 2016. Methodology. A hospital-based cross-sectional study was conducted, and a total of 342 urine samples were cultured on MacConkey agar for the detection of etiologic agents. Double-disk synergy (DDS) methods were used for detection of ESBL-producing strains. A disc of amoxicillin + clavulanic acid (20/10 µg) was placed in the center of the Mueller–Hinton agar plate, and cefotaxime (30 µg) and ceftazidime (30 µg) were placed at a distance of 20 mm (center to center) from the amoxicillin + clavulanic acid disc. Enhanced inhibition zone of any of the cephalosporin discs on the side facing amoxicillin + clavulanic acid was considered as ESBL producer. Results. In the current study, ESBL-producing phenotypes were detected in 23% (n = 17) of urinary isolates, of which Escherichia coli accounts for 76.5% (n = 13) and K. pneumoniae for 23.5% (n = 4). ESBL-producing phenotypes showed high resistance to cefotaxime (100%), ceftriaxone (100%), and ceftazidime (70.6%), while both ESBL-producing and non-ESBL-producing isolates showed low resistance to amikacin (9.5%), and no resistance was seen with imipenem. In the risk factors analysis, previous antibiotic use more than two cycles in the previous year (odds ratio (OR), 6.238; 95% confidence interval (CI), 1.257–30.957; p = 0.025) and recurrent UTI more than two cycles in the last 6 months or more than three cycles in the last year (OR, 7.356; 95% CI, 1.429–37.867; p = 0.017) were found to be significantly associated with the ESBL-producing groups. Conclusion. Extended-spectrum β-lactamases- (ESBL-)producing strain was detected in urinary tract isolates. The occurrence of multidrug resistance to the third-generation cephalosporins, aminoglycosides, fluoroquinolones, trimethoprim-sulfamethoxazole, and tetracyclines is more common among ESBL producers. Thus, detecting and reporting of ESBL-producing organisms have paramount importance in the clinical decision-making.


2014 ◽  
Vol 63 (2) ◽  
pp. 229-234 ◽  
Author(s):  
Kamel Adwan ◽  
Naser Jarrar ◽  
Awni Abu-Hijleh ◽  
Ghaleb Adwan ◽  
Elena Awwad

Antibiotic resistance of Escherichia coli isolated from urinary tract infections (UTIs) is increasing worldwide. A total of 41 E. coli isolates were obtained from urine samples from hospitalized patients with a UTI in three hospitals in the northern districts of the West Bank, Palestine during March and June 2011. Resistance rates were: erythromycin (95 %), trimethoprim–sulfamethoxazole (59 %), ciprofloxacin (56 %), gentamicin (27 %), imipenem (22 %), amoxicillin (93 %), amoxicillin–clavulanic acid (32 %), ceftazidime (66 %) and cefotaxime (71 %). No meropenem-resistant isolates were identified in this study. Among the isolates, phylogenetic group B2 was observed in 13 isolates, D in 12 isolates, A in 11 isolates and B1 in five isolates. Thirty-five of the isolates were positive for an extended-spectrum β-lactamase phenotype. Among these isolates, the bla CTX-M gene was detected in 25, and eight harboured the bla TEM gene. None of the isolates contained the bla SHV gene. Transformation experiments indicated that some of the β-lactamase genes (i.e. bla CTX-M and bla TEM) with co-resistance to erythromycin and gentamicin were plasmid encoded and transmissible. Apart from this, enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR) revealed that the 41 isolates were genetically diverse and comprised a heterogeneous population with 11 ERIC-PCR profiles at a 60 % similarity level.


2014 ◽  
Vol 27 (6) ◽  
pp. 737 ◽  
Author(s):  
Rui Passadouro ◽  
Raquel Fonseca ◽  
Felícia Figueiredo ◽  
Andreia Lopes ◽  
Cristina Fernandes

<strong>Introduction:</strong> The urinary tract infections, after respiratory infections, are the most common in the community. The knowledge about the prevalence of microbial strains and their antibiotic susceptibility is crucial to establish an effective empirical therapy. The aim of this study was to determine the antibiotic susceptibility patterns of bacterial strains isolated from positive urine cultures performed in patients from the central region of Portugal.<br /><strong>Material and Methods:</strong> We carried out a documental analysis of 6008 urine bacteriological exams, to be made available to physicians, most of which run through the automated system VITEK 2, bioMérieux. The majority (80%) of the urine bacteriological exams were from female. Escherichia coli was the most prevalent bacterial pathogen (65.9%), followed by Klebsiella spp (12%).<br /><strong>Results:</strong> Nitrofurantoin showed high levels of activity (96%) for Escherichia coli, as well as Fosfomycin (96.6%). Amoxicillin-clavulanic acid presents an activity level of only 81.1% for the same germ. Quinolones exhibit efficacy to only 78% of the strains of Escherichia coli, below the Fosfomycin and Nitrofurantoin. Nitrofurantoin showed high levels of activity (96%) for E. coli as well as Fosfomycin (96.6%). Amoxicillin-Clavulanic Acid presents a level of activity of only 81.1% for the same germ. The quinolones have a efficacy for only 78% of strains of E. coli, lower than Fosfomycin.<br /><strong>Discussion:</strong> Escherichia Coli was the most prevalent uropathogen (65.9%). High efficacy against this pathogenic agent was found for Fosfomycin (96.6%) and Nitrofurantoin (96%).<br /><strong>Conclusion:</strong> Further antimicrobial surveillance studies should be developed, in order to formulate local empirical therapy<br />recommendations for optimized therapeutical choices.<br /><strong>Keywords:</strong> Urinary Tract Infections; Drug Resistance, Bacterial; Anti-Bacterial Agents; Community-Acquired Infections.<br />


Author(s):  
Ishrath Razia Riaz ◽  
Anusha Hindupur ◽  
Akhil Raj Thota ◽  
Arulmozhi Balakrishnan ◽  
Iswarya Anbazhagan ◽  
...  

Introduction: Urinary Tract Infections (UTI's) are considered to be one of the most prominent infections, worldwide. Klebsiella species are the commonest cause of community and hospital acquired UTIs. Biofilm production and hyper-mucous production are the important virulence factors among the pathogenic strains of Klebsiella species. Biofilm-associated and Hyper-Mucoviscosity (HMV) variants of Kiebsiella spp. ispotent enough to easily colonise the urinary tract, develop the invasiveness of infection and mainly contribute in higherresistance to most classes of antibiotics. Understanding the virulence factors associated with Multi Drug Resistant (MDR) Klebsiella spp. would aid in estimating the resistance related mortality. Aim: To identify and comparatively analyse the HMV, biofilm-producing capacity and drug resistance pattern of archived Klebsiella spp. isolates from UTI. Materials and Methods: This study was a cross-sectional, descriptive study. A retrospective analysis was performed during January 2020 to March 2020 on 207 archived Klebsiellaspp. isolates collected between December 2017 to January 2019. The presumptive identification of Klebsiella spp. was done using standard microbiological techniques. Antimicrobial susceptibility test was performed as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Klebsiella spp. were tested for biofilm production using microtiter plate method and HMV phenotype by string test. Descriptive statistics and Student’s t-test were performed to analyse the data. Results: A total of 207 Klebsiella isolates were used in this study and majority (94.6%) of the isolates were identified as Klebsiella pneumoniae subsp. pneumoniae. Out of 207 isolates, 14 isolates (6.8%) were Extensively Drug Resistant (XDR); 141 isolates (68.1%) were MDR; 43 isolates (20.8%) were resistant to one or two class of antibiotics. Biofilm detection assay showed 97.1% (201/207) were strong biofilm producers and 2.9% (6/207) were moderate biofilm producers. String test for HMV detection showed only two isolates (1.0%) were positive HMV producers. Among the biofilm producers, majority of the Klebsiella isolates were found to be MDR. Conclusion: Resistance in Klebsiella spp. is an evolving problem. Majority of the drug resistant Klebsiella isolates used in present study were strong biofilm producers. This study emphasises on the sensible use of last resort drugs to cut down the evolution of resistant strains.


2021 ◽  
Vol 9 (1) ◽  
pp. 075-085
Author(s):  
Abdoulaye Makanéra ◽  
Talibi Camara ◽  
Amadou Sadjo Diallo ◽  
Rabouan Mohamed Chamassi ◽  
Mariam Condé ◽  
...  

Introduction: Escherichia coli (E. coli) is one of the main bacterial species associated with urinary tract infections. Nowadays, this bacterium is becoming more and more resistant to antibiotics. Objective: The aim of this study was to determine the antibiotic sensitivity profiles of all strains of E. coli isolated from urine during the period from September 1st, 2018 to March 13th, 2019 at the Biomedical Laboratory of the China-Guinea Friendship Hospital of Kipé in Conakry. Materiel and Methods: Cultures were done on different agar media. Bacterial identification, antibiograms and determination of minimum inhibitory concentrations (MIC) were performed on the Vitek 2 Compact 15 automated system. Results: A total of 66 strains of E. coli have been isolated from patients of both sexes. The sex ratio (M/F) was 0.43. The mean age of the patients was 50.83 years. The majority of strains were sensitive to imipenem (96.96%), amikacin (96.96%), ertapenem (94.73%), gentamicin (69.23%), tobramycin (60, 60%), cefoxitin (64.28%), cefotaxime (62.50%), piperacillin/tazobactam (77.4%), amoxicillin/clavulanic acid (50.00%) and nitrofurantoin (87%). In contrast, the majority of strains were resistant to ampicillin (81.81%), cefalotin (62.02%), ticarcillin (88.00%), nalidixic acid (82.75%), ciprofloxacin (56.06%), ofloxacin (56.00%) and combination of trimethoprim/sulfamethoxazole (83.60%), sometimes with high MICs. Conclusion: Our results show that urinary tract infections due to E. coli are more frequently observed in females than in males. Some of these strains studied exhibited multidrug resistance profiles to antibiotics. Among the classes of antibiotics tested, carbapenemes, nitrofurans, aminoglycosides, appear to be more active on E. coli uropathogenes in Guinea.


2016 ◽  
Vol 73 (12) ◽  
pp. 1109-1115
Author(s):  
Zorana Djordjevic ◽  
Marko Folic ◽  
Slobodan Jankovic

Background/Aim. Urinary tract infections (UTIs) are among the most common infections in outpatients. The aim of this study was to define the causative agents of urinary tract infections and their resistance to antimicrobial drugs in the urban area of central Serbia, as well as to evaluate eventual differences associated with age and gender of the patients. Methods. This retrospective study analysed data taken from routine, consecutively collected urine cultures of outpatients with symptomatic UTIs, collected from the Department of Microbiology, Institute of Public Health in Kragujevac, Serbia, from January 2009 to December 2013. Results. There were 71,905 urine cultures, and 24,713 (34.37%) of them were positive for bacterial pathogens. The most common pathogen was Escherichia coli (E. coli) (56.56%), followed by Klebsiella spp. (16.20%), Proteus spp. (14.68%), Enterococcus spp. (5.29%) and Pseudomonas aeruginosa (3.74%). E. coli and Enterococcus spp. isolation rates were lower in males ? 60 years old (23.71% and 4.87%, respectively), while Klebsiella spp. was more prevalent in this group (32.06%). The most common causative agents isolated from 15?29 years old male patients were Enterococcus spp. and Pseudomonas aeruginosa (13.28% each). Among women, the isolation rate of E.coli was high in all age groups (around 70%). Proteus spp. was frequently isolated from females ? 14 years old (13.27%), while Klebsiella spp. was the most frequent in the oldest age female group (10.99%). Conclusion. Choice of antibiotics for treatment of UTIs should be governed not only by the local resistance patterns, but also by gender and age of patients.


Author(s):  
Mihaela Elena Idomir ◽  
Carmen-Sarah Costinaș

The aim of the retrospective study was the analysis of antibiotic resistance patterns of bacteria involved in urinary tract infections in patients hospitalized during 2019 in the Intensive Care Unit of the Clinical County Emergency Hospital Brasov. The main bacteria involved were Escherichia coli (38,68%), Klebsiella species (23,69%) and Enterococcus species (15,68%). Various degrees of resistance to the tested antibiotics were observed. ESBL strains were detected at Escherichia coli (20,72.%) and Klebsiella species (10,29%). Carbapenem resistant strains were detected at Klebsiella spp. (48,48%), P. aeruginosa (56,25%) and Acinetobacter spp. (85,71%). MRSA, VRE and HLAR strains were also detected in the studied group.


Antibiotics ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 284 ◽  
Author(s):  
Olga Maria Rostkowska ◽  
Robert Kuthan ◽  
Anna Burban ◽  
Jagoda Salińska ◽  
Michał Ciebiera ◽  
...  

Background: Urinary tract infections (UTIs) are the most common bacterial infections among kidney transplant (KTX) recipients. The purpose of this study was to analyze antimicrobial resistance (AMR) in four most common pathogens responsible for UTIs in KTX recipients and determine risk factors (RF) for resistance in the same group. Methods: Analyzed antibiograms were based on urine samples positive for bacterial growth of 105 colony-forming units (CFU)/mL obtained from hospitalized adult KTX recipients presenting with UTI symptoms upon admission to the center in years 2011–2018. Results: In total, 783 antibiograms were analyzed for Klebsiella pneumoniae (258 samples, 33.0%), Escherichia coli (212, 27.0%), Enterococcus faecalis (128, 24.0%), and Enterococcus faecium (125, 16.0%). The decrease in susceptibility of E. coli to amoxicillin/clavulanic acid (62.9% vs. 40.0%) and ciprofloxacin (100% to 40.0%) was observed. Susceptibility to gentamicin increased from 33.3% to 92.9% in E. faecium. Susceptibility to tigecycline remained 100% through all years in case of E. faecalis and E. faecium. Male gender was a RF for resistance to amoxicillin/clavulanic acid (p = 0.008), ciprofloxacin (p = 0.0003), trimethoprim/sulfamethoxazole (p = 0.00009), ceftriaxone (p = 0.0001), and cefuroxime axetil (p = 0.00038) in K. pneumoniae and against gentamicin in E. faecalis (p = 0.015). Higher resistance to ampicillin in E. faecalis (p = 0.012) and to ciprofloxacin (p = 0.0003), trimethoprim/sulfamethoxazole (p = 0.007), piperacillin/tazobactam (p = 0.003), ceftriaxone (p = 0.001), and cefuroxime axetil (p = 0.013) in K. pneumoniae was observed in higher age groups of patients. Diabetes as a cause of kidney insufficiency (p = 0.026) and kidney-pancreas transplantation (p = 0.014) was RF for resistance to ceftriaxone in K. pneumoniae. Conclusions: AMR in uropathogens from KTX recipients fluctuated. There were identifiable RFs for resistance in the examined bacteria–antibiotic combinations. We recommend continuous mapping of site-specific microorganisms as etiology and susceptibility may vary between institutions and over time.


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